Akshata, A S (2012) A study on the influence of incision on post operative astigmatism in manual small incision cataract surgery. Masters thesis, Stanley Medical College, Chennai.
|
Text
2203002akshataas.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: When assessing recent changes in modern cataract and intraocular implant surgery,the single most pressing challenge faced by surgeon today is the need to achieve predictable and accurate refractive outcomes.Recent progress in cataract surgery has heightened patient expectations and having a good post operative uncorrected visual acuity is considered a norm. The control of postoperative astigmatism is the key in meeting these expectations.The concept of surgically induced astigmatism has added entirely unique dimension to cataract surgery with emphasis more focussed on refractive aspect of surgery in present era. Over the years a better understanding of various preoperative and intraoperative determinants of surgically induced astigmatism has made it possible to actually plan out the surgical intervention and their modification according to preoperative state of astigmatism of patient in order to achieve minimum possible post operative astigmatism. The purpose of modern cataract surgery is not only cataract extraction followed by IOL implantation but also to reduce or correct existing astigmatism. PRESENT STUDY: The cataract incision is much more than just being a port of access to anterior chamber. It is a most important structural variable in cataract surgery. In this context we have undertaken a study designed to determine the significance of effects of various types of incision like superior, temporal & superotemporal incision depending on steeper axis and its effect on pre-existing astigmatism. AIM OF THE STUDY: To determine the outcome of incision at steeper meridian in Manual Small Incision Cataract Surgery with IOL implantation in reducing the preoperative astigmatism. To evaluate the type of post operative astigmatism. To assess the change in the pattern of corrected astigmatism over a period of 6 months. MATERIAL AND METHODS: This study of evaluating the outcome of incision at steeper meridian in reducing pre-operative astigmatism in manual small incision cataract surgery. Duration: December 2009 to October 2011 at Stanley Medical College, Chennai Sample size: 100 eyes of 100 patients who underwent cataract surgery with pre operative astigmatism more than 0.75 to 2.5diopter were enrolled in the study. Intervention: Manual small incision cataract surgery with IOL implantation with straight incision at steeper meridian Study design: Prospective interventional case series study. Full informed consent was taken from all patients after explaining procedure in their local language. Ethical clearance was obtained from the ethical committee of our institute. OBSERVATIONS AND DISCUSSION: As mentioned in materials and methods section 100 eyes of 100 patients who underwent manual small incision cataract surgery were evaluated for preoperative and postoperative astigmatism. All the patients completed 6 months follow up. Data was entered on the excel spreadsheet. RESULTS: Among the pre operative details in 79% patients had vision between PL+ to 6/60 & 21% had vision between 6/36 to 6/18. Mean preoperative astigmatism was 1.46 D. CONCLUSION: Incision at steeper meridian is a simple, safe, effective procedure to correct mild to moderate preoperative astigmatism at the time of cataract surgery. Post operative vision & astigmatism remained stable over a period of 6 months of follow up in superotemporal group & temporal group while superior incision group showed fluctuation in astigmatism in initial 6 weeks post operatively which stabilized over a period of 6 months. Due to change in the surgical orientation, temporal & superotemporal approach may require little practice, if one considers the preoperative astigmatism when selecting the location of incision in MSICS, one an minimize post operative keratometric surgically induced astigmatism. A simple modification in incision placement produces comparable results to other sophisticated procedures & hence offers a way to attain better surgical outcome with limited resources available in most of the set ups.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | post operative astigmatism; manual small incision cataract surgery |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 13 Sep 2017 11:46 |
| Last Modified: | 13 Sep 2017 11:46 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3130 |
Actions (login required)
 |
View Item |
